Anxiety Disorders and Sleep Disorders

A good night’s sleep is important to good health. Many of us toss and turn or watch the clock when we can’t sleep for a night or two. But for some, a restless night is routine. More than 40 million Americans suffer from chronic, long-term sleep disorders, and an additional 20 million report sleeping problems occasionally, according to the National Institutes of Health. Stress and anxiety may cause sleeping problems or make existing problems worse. And having an anxiety disorder can only exacerbate the problem.

What is an anxiety disorder?Anxiety disorders are a unique group of illnesses that fill people’s lives with persistent, excessive, and unreasonable anxiety, worry, and fear. They include generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and specific phobias. Anxiety disorders are real, serious medical conditions, but they can be treated.

What is a sleep disorder?Sleep disorders are conditions characterized by abnormal sleep patterns that interfere with physical, mental, and emotional functioning. Stress or anxiety can cause a serious night without sleep, as do a variety of other problems. Insomnia is the clinical term for people who have trouble falling asleep, difficulty staying asleep, waking too early in the morning, or waking up feeling unrefreshed. Other common sleep disorders include sleep apnea (loud snoring caused by an obstructed airway), sleepwalking, and narcolepsy (falling asleep spontaneously). Restless leg syndrome and bruxism (grinding of the teeth while sleeping) are conditions that also may contribute to sleep disorders.

Does an anxiety disorder lead to a sleep disorder, or does a sleep disorder cause an anxiety disorder?Either is possible. Anxiety does cause sleeping problems, and new research suggests sleep deprivation can cause an anxiety disorder. That’s because a lack of sleep stimulates the part of the brain most closely associated with depression, anxiety, and other psychiatric disorders. Research also shows that some form of sleep disruption is present in nearly all psychiatric disorders.

For those living with anxiety disorders, insomnia is part of a vicious cycle. Many symptoms of anxiety disorders, including excessive stress, persistent worry, obsessive thoughts, gastrointestinal problems, and nightmares are likely to rob precious sleep. And some antidepressants commonly prescribed for anxiety disorders may cause sleep difficulties.
Other research suggests that sleep deprivation results in people focusing on negative emotions, according to Mark H. Pollack, MD, director of the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital. Pollack says this can decrease the effectiveness of exposure-based cognitive-behavioral therapy.

If I have a sleep disorder, does that put me at risk for other health issues?The risks of inadequate sleep extend way beyond tiredness. Sleeplessness can lead to poor performance at work or school, increased risk of injury, and health problems.

“Ninety percent of the time people who have insomnia also have another health condition,” says Thomas Roth, PhD, director of the Sleep Disorders and Research Center at Henry Ford Hospital. “Most frequently those include anxiety and mood disorders, and treating each condition impacts the course of the other.” Those with sleep disorders may also be at risk for heart disease, heart failure, irregular heartbeat, heart attack, high blood pressure, stroke, and diabetes. And some researchers say that adults who sleep less than six hours a night are 50 percent more likely to become obese than those who sleep seven to eight hours a night.

What are my treatment options?It’s important to obtain an accurate diagnosis for any medical conditions that may contribute to a sleep disorder or anxiety disorder, as well as to determine which is the primary condition. This information will help you and your doctor determine the most appropriate treatment plan.

If you suspect you have a sleep disorder, see a primary care physician or mental health professional, or visit a clinic that specializes in sleep disorders. Treatment options include sleep medicine and cognitive-behavior therapy, which teaches how to identify and modify behaviors that perpetuate sleeping problems.

Treatment options for an anxiety disorder include cognitive-behavior therapy, relaxation techniques, and medication. Your doctor or therapist may recommend one or a combination of these treatments.

What else can I do to reduce anxiety and sleep more soundly?

To reduce anxiety and stress:

Meditate: Focus on your breath — breathe in and out slowly and deeply — and visualize a serene environment such as a deserted beach or grassy hill.

Exercise: Regular exercise is good for your physical and mental health. It provides an outlet for frustrations and releases mood-enhancing endorphins. Yoga can be particularly effective at reducing anxiety and stress.

Prioritize your to-do list: Spend your time and energy on the tasks that are truly important, and break up large projects into smaller, more easily managed tasks. Delegate when you can.

Play music: Soft, calming music can lower your blood pressure and relax your mind and body.

Get an adequate amount of sleep:
Sleeping recharges your brain and improves your focus, concentration, and mood.

Direct stress and anxiety elsewhere:
Lend a hand to a relative or neighbor, or volunteer in your community. Helping others will take your mind off of your own anxiety and fears.

Talk to someone:

Let friends and family know how they can help, and consider seeing a doctor or therapist.

To sleep more soundly:
Make getting a good night’s sleep a priority. Block out seven to nine hours for a full night of uninterrupted sleep, and try to wake up at the same time every day, including weekends.
Establish a regular, relaxing bedtime routine:
Avoid stimulants like coffee, chocolate, and nicotine before going to sleep, and never watch TV, use the computer, or pay bills before going to bed. Read a book, listen to soft music, or meditate instead.

Make sure your bedroom is cool, dark, and quiet: Consider using a fan to drown out excess noise, and make sure your mattress and pillows are comfortable.

Use your bedroom as a bedroom: Not for watching TV or doing work — and get into bed only when you are tired. If you don’t fall asleep within 15 minutes, go to another room and do something relaxing.

Exercise: Regular exercise will help you sleep better, but limit your workouts to mornings and afternoons.

Avoid looking at the clock: This can make you anxious in the middle of the night. Turn the clock away from you.

Talk to your doctor if you still have problems falling asleep. You may need a prescription or herbal sleep remedy.
Excerpt from the website of the Anxiety Disorders Association of America.

Excerpt from the website of the Anxiety Disorders Association of America.